SB2800 103RD GENERAL ASSEMBLY

LRB103 36093 KTG 66182 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB2800

Introduced 1/17/2024, by Sen. Ram Villivalam

SYNOPSIS AS INTRODUCED:

305 ILCS 5/5-5.08a new

Amends the Medical Assistance Article of the Illinois Public Aid Code. Provides that beginning January 1, 2025, renal dialysis services provided within a skilled nursing facility by a certified home dialysis provider shall receive a per-claim add-on payment of $95 per treatment. Defines "certified home dialysis provider" to mean an end stage renal disease facility that (i) provides dialysis treatment or dialysis training to caregivers or individuals with end stage renal disease and (ii) has been approved to provide dialysis home training support services by the federal Centers for Medicare and Medicaid Services. Effective January 1, 2025.

A BILL FOR

AN ACT concerning public aid.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Public Aid Code is amended by adding Section 5-5.08a as follows:

(305 ILCS 5/5-5.08a new)

Sec. 5-5.08a. Renal dialysis; add-on payments for skilled nursing facilities.

(a) Findings. The General Assembly finds the following:

(1) Home dialysis services provided on-site at skilled nursing facilities are beneficial to nursing home residents by permitting more time for other health and wellness activities, and nullifying burdensome off-site travel which carries various healthcare risks and increased costs.

(2) Home dialysis for nursing home residents provides an on-site venue for high-acuity residents to receive dialysis services, effectively creating downstream care opportunities for hospital patients in need of post-acute care and dialysis, and reducing the total cost of dialysis care.

(3) On-site home dialysis in nursing homes is costlier for the provider than conventional outpatient dialysis, as labor costs are greater per treatment and such patients typically have higher acuities, necessitating more medication and greater staff involvement to promote patient compliance.

(b) For home renal dialysis provided to residents of skilled nursing facilities, the Department shall reimburse a per-claim add-on payment in accordance with this Section. Beginning January 1, 2025, renal dialysis services provided within a skilled nursing facility by a certified home dialysis provider shall receive a per-claim add-on payment of $95 per treatment. As used in this Section, "certified home dialysis provider" means an end stage renal disease facility that (i) provides dialysis treatment or dialysis training to caregivers or individuals with end stage renal disease and (ii) has been approved to provide dialysis home training support services by the federal Centers for Medicare and Medicaid Services.

Section 99. Effective date. This Act takes effect January 1, 2025.